IndeFree Hawaii 2010

Patients fit a different mold in today's world Do you have the ability to create a program? Stages, prices, excitement Recovery audit contractors are private businesses The government is putting a bounty on our heads Now it's 50 cents on the dollar It's the government's attempt to take money back to continue Medicare It's cloaking fraud to get money back for Medicare

 They're going after anybody TAG Therapist Advocacy Group How do you do your documentation now so your safe Simple procedures to put policies in place PTs are the weakest group in the medical professional associations Nkinzi from St. Thomas Virgin Islands Kimber Glick Ergonomist Loves to kayak Grant from Oahu Outpatient ortho

 Katie PT from hawaii EOL end of life situation Everything is the way you package it Package it well People are going to do it What's working is getting your program out to consumers Who physicians listen to are their patients The channel to go through is the consumer Sean daly from s. Carolina Likes running, golf, cycling

 Angel from Seattle Share 4 years of learning in days It's a vision that you need Life happens You're going to forget things We learn best face to face We learn best by interacting Just implement one thing Carry it out 100% You'll get your money back by implementing one thing Pick only one or two things to implement

 We're stubborn, anal, meticulous We all share the same qualities as doctors, dentists, and nurses We're the most generous, giving, humanitarian What do you have to do to beat everybody else? To win the superbowl? What do you practice? Why are you looking for their weaknesses? To exploit them This is how you win

 Do you think insurance companies know your weaknesses are? They what's probably going to happen to those few claims they deny They know your floor has many holes People who go in business suck in business If they confuse you a little bit they suck up the money that falls through the cracks #1 way of making the money that fell through your cracks Lot of steps in getting paid Need to have a good business in order to get paid

 Make money screwing you because your bad at business Terminally ill people will not sue because they don't have money or the where withal to get an attorney The government says it's ok to let people die in the name of profit You have to let people to die to be a super power How do you fight these monsters? Angel from Seattle What I did that lead to failure Sharing with you what I learned from my failure I did the opposite of what lead to failure

 Some of the things that were opposite was so crazy Some of the things you think you need to do to be successful you would never think of doing it Success is such a secret These introductions are part of this class What you do in the beginning is not the same as at the end Winning the lottery, it can destroy you Getting too much too fast, you won't apply anything If I dislike you, this class won't be very good There's a reason why you're excited for three weeks after the course

 Do one thing Veer off so you can start going up higher You have to veer in order to get it You can't think the same things and think that its somehow going to magically change Thinking new thoughts produce different results Looking back the reason why my second practice became successful was #1, because I said I was going to do the opposite of what I did before I could be wrong I thought I was right about my life Can't live by principle

 Accept the fact that I could be wrong I'm going to be a river and not a rock That decision to be like a river Not to be so steadfast and strong Their spouses love them They can sleep at night We all think alike The way people on this path think This what will change your life Thinking which leads to the action of a successful person I may be wrong

 When I think I'm so right I start thinking I could be wrong Most of the time I'm like a river Most people have preferences, not principles Accept new ideas Potentially adopt new ideas Successful give up control They don't try to control everything We don't control anything but what we say, think, and do Unsuccessful people think they own their money, when you don't Act, treat, and spend it differently

 Unsuccessful people think they own everything Successful people know what a goal is Have to know what is means in order to achieve it Unsuccessful people don't realize they're wishfully think more Goal: a dream with a deadline I want a practice valued at a miliion dollar in one year I want to build a million dollar practice in a year Crazier things have happened than that What else does a successful person think

 Successful people Expect that they're going to be misunderstood Make my dining an experience, I tip 100% Don't do the status quo Successful people send messages all the time They don't wait for birthdays to send gifts What does money mean to you "Money is a unit of choice" This is tough to adopt Money is options That you know how to make choices

 That you have no fear to make choices If you do not make decisions without fear, you will not be entrusted with more If you make decisions without fear If you know how to do it and you do it, you will be entrusted with more If you spend it differently you will be entrusted with more A dream is something you've never done with a deadline Now you are equipped to live a life of fulfilling dreams Successful people live a life fulfilling dreams Who are you?

 This is the definition for you to be successful in life I don't know who you are Who are you Most don't know Can't have success without it "I am worthy" I actually wanted my first business to fail I didn't feel like I deserved to have it My subconscious believed that you got to suffer You got to pay your dues I hadn't suffered enough

 I haven't paid it yet Sss subconscious self sabotage It's a disease Instead of doing the things I needed to do I found myself doing things that were familiar I would do things like cleaning You cannot sabotage your own success You are worthy Not judged by past failure Despite past failures who are you going to be today

 You are the only one judging yourself It took losing my practice to realize something I'm clean I walked through fire I paid my dues I can enjoy success You don't need to suffer Hoping that you will succeed and be a new you How you respond despite your past sins and mistakes You were judging others by their worst sins and mistakes

 When you change You can say I am not that person Treat others by who they are today Once you treat others this way you begin to realize your worthiness Judge others by how they respond to being confronted You must tell employees how to respond to their mistakes They don't know what to do to respond to a mistake Apologize and do something she wouldn't expect A mistake equals an opportunity to make the relationship better

 They love you more after the mistake Nothing will cost you more than having one wrong person in the wrong position Some people are not ready for success Those people you cannot have in your organization They are like a cancer Breath of fresh air when they are gone I fire people very easily and very quickly Must become a decision maker to be entrusted with more money Does this make my business more simple, focused, or automated Then do it

 If not, don't do it Your saying I want my life to be more confusing and harder That's SSS Do whatever it takes to do it The decisions you make are sending messages Even fools learn from their own mistakes The wise learn from the mistake of others That's me I needed to do it myself I believed it this way I'm a pioneer

 Learn through the mistakes of others Another form of indecision When you say in your mind I'll wait and see Failure gives you opportunities to avoid it Kept saying I'll wait and see rather than jumping on these opportunities I feared making decisions I waited and see when there were no other options available I don't even let it seep in After you make that decision you can wait The reason why he doesn't know

 This is how unsuccessful people make decisions, the make pros and cons They become indecisive because pros and cons don't work Where is it you want to be Is that decision in line with where it is you want to go Most have never set a goal They've never defined it Can't reach a goal that's undefined Where is it you want to be? Be clear Define where it is you want to be That is how you avoid indecision

 First define how are you're going to walk away What are you trying to build and how do you walk away Define it for me Until you change your mind, you need a direction If you don't define it One day you'll be asking yourself how the hell did I get here Where is it you want to go? Where is it you want to be? How do I walk away? You will start to notice financial gain

 Successful people do not allow sss to overtake them They thing they own everything They think they deserve everything Your parents did all the things that led to you crappy job Our parents believed you have to pay you dues They believed you must do what you hate because that's part of success You must do all those hard things in order to be successful A business will bring you independence and freedom Anything you don't like to do you got to pay somebody else to do it

 I don't do what I don't like Anything you don't want to do pay somebody else The things you can't pay someone else to do I don't do things for her that I don't want to do Learn how to get things done where people can't steal Not your employees job to bring in more business Your job is to make decisions in training In making decisions to bring more business in the door You got to focus on bringing people through the door

 Do what you can afford Job is to make decisions knowing that you don't control the outcome Unsuccessful people get a big head Successful people realize a decision is a decision and I have no clue as to the results Successful people don't get a small head or a big head I'm very happy it happened this way Successful people know they don't control the outcome That's why they don't have fear When you go home and you check your mail

 Look through that stack It's a symptom of fear making that decision Throw it away If you don't need it that moment throw it away She was swimming in SSS If I spend time cleaning the house I'm losing money Her financial gaining abilities is worth more than that Another symptom of SSS Spending time to save money Spend money on convenience

 Spend money to have a better quality of life If you don't enjoy doing it ask what is it bringing in to me I need to do it myself if I need to do it right You need to control that This is something I need to control to be successful You are saying you control your success when you don't Anytime it can be taken away Let their kids be whoever they want to be Realize I don't own them

 There is nothing in your business that is directly related to success Don't even be thinking about office supplies That's somebody else's job Spend an hour thinking about a martial arts program Create a program I guarantee you the child is going to be better, faster, stronger than before their injury Don't think any amount of your time is disposable Becoming a mountain mover is to become an achiever

 Have to become a mountain mover to have the most successful practice Until you do things, something new You will never have something you never had Are you ready to do things you never done? Are you ready to think thoughts you never thought? When, how much, where, why First steps first When do you want to see it finished It can be a goal It's not done yet

 Break it down into three's #1 reason why a website never gets done It's not mapped out Don't rely on someone else for growth Can't be dependent on referral types Can't be dependent on workman's comp 30% cut in medicare starting 2011 I don't like being dependent on any one or two channels Break it down into three broad categories What 3 major steps do you have to make?

 Done with our strategy and plans in 60 days Go through the plan Look at everything you're spending through your business I want to know everything Even split that up into categories of fixed or variable This exercise will help you make money Go through every expense item that you don't get a return on, cross it out There's an inherent value, keep it Your mortgage does not bring a 3x return

 A bed that is too large is bad for relationships Look at what you have that is of value List your interests List your talents List community needs Find the one thing that overlaps in all three areas That's your first program Just sell 4x month Determine something that you can package and offer When you offer it, someone will buy it

 You can sell anything you want You can package it You can sell it Have the option to break it up into payments Give people options in the way they pay If they qualify for financial hardship How do you collect the money This is my program, $3,000 a month Start with a $3,000 package You're going to get one a month It sounds easy

 You've just never done it What are the features and benefits of it What can the person expect Who's the best type of people for this program Break each step down into three steps Focus on one thing Focus on your check list All you have to do is take the first step Don't focus on if you see it happening Just do this and do that If you do it will happen

 3rd thing to do with your mail: do it Unsuccessful people will try to hold onto that money and spend the next 3 months thinking about that bill Stop thinking your going to get better by waiting A bill is a fire Extinguish it as quickly as possible Pay your bills as quickly as possible Throw it away File it away Whatever it is just do it Control your mail on a daily basis

 It will carry over into your business You get to control your time Most people feel like they don't have time Like something else controls them so they can't control their time The way you spend time is with people How not to spend energy Don't spend it worrying about how you are going to pay the rent, or put food on the table If you don't have energy, assess what you are worrying about Release control of keeping that roof over your head

 So be it if it gets taken away Your energy should be spent on creating ways to fulfill needs Creating ways to fulfill needs New innovations Focus on needs and package some new products or services Napoleon Hill "Think and Grow Rich" Spend your energy creating How would you feel if I lost everything She was so sincere As long as I have you I'm good She demonstrated it

 I want spend the rest of my life with this person Someone can come and take it all away Your job is to be prepared to respond with dignity and grace Hey I'm suffering Do you think they helped me? How do you feel about that? Do you know why it's cut throat? There's value in securing a solution for someone they love Majority of people would benefit from what we know

 I don't want to share my piece of pie with you I'm dead if you start taking my patients Taste of what it's like to tap into the other 96% In less than a year and a half your goal is to close your doors and only take patients referred by your existing patients Your greatest compliment is bringing in a family member or friend on your next visit Only do back door business What are you doing to get them to bring another patient in Best patients are the one's brought in by another one

 How many patients have been brought in In the past 30 days Tapping into that duplication How do you harness that power of duplication First place I look in a suffering practice The front desk First sign of a suffering practice Post its everywhere #1 reason they leave They hate the front desk Today's a new day

 Front desk is responsible for getting someone to bring in another patient Second reason is financial ambiguity You should have a website The receptionist lied to me about needing a script from the doc in order to be evaluated That I have to have a physician's referral Must have a medical diagnosis to initiate treatment You can treat if there is a medical diagnosis It's your duty to do the evaluation She doesn't know

 She's never been trained How to activate Front desk will make or break your practice What to say Different caller profiles How do you get new business in the door? Website is the number one thing to generate new business Showing up in top 5 on google Only viewed by 12% if you're on second page

 Google is where 54% of all searches are done on the internet Reasons why you should choose us If you don't have it written If you don't know why people should do business with you How do you become the first one on the list Be wary of companies that charge a monthly fee Secrets to attracting new patients They have not decided what type of new patient they want Do you want to get more in network patients?

 You want to diversify That's the secret to getting new patients You squeeze three times as hard to get one third the juice Your message has to be loud and clear Do you have high deductible insurance? We can help We can discount that deductible if you have financial hardship Got to determine what channel you want more The message changes depending on who you want to attract What kind do you thinks more

 Personal injury pays without discounting Best paying third party Cash system is critical Did she give me any information to like her Your receptionist is doing the exact same thing Knowing what to do and say Most receptionist don't say I lost him Every day you are losing people but your receptionist is not telling you Personal injury is the best paying Cash is the most convenient

 The best one is the HMO Always sending patients out HMO's don't stall It takes time Demonstrate you're going to be around. The secret to business is getting people to do business with you You want to do business with people who are brilliant People don't like doing business with people who say no Always ask a question Negotiate through a question

 The trained receptionist is the one who gets patients in How's your experience? Patient loyalty is different than patient satisfaction What is a loyal patient You don't want satisfied patients The instant something better comes along they jump ship I will die for you, that's loyalty The instant someone better looking comes along, or connects with someone better emotionally They'll admire you until you blow it

 I'm here, I could care less about the competition What are you doing to earn that? Over 70% in all relationship there is cheating We don't know how to cultivate loyalty Can you love somebody and they cheat on you? All the time How do you earn loyalty? Worker's comp is a good channel Have to send the message you have payment plans available How to get more Medicare patients

 It would be nice to have a services brochure Top 10 Reasons to Choose Us brochures Medicare patients want educational materials They read them Laser brochure is so popular Laser is all cash You have two options Send a survey and ask MDs what kind of free classes that they would like to make available for their patient Make a brochure for the class Offer the class for them

 #1 class they want to see is a pre and post op joint replacement class Surgery is good During outpatient they're not getting what they need to The quality of the surgeon is not being preserved It's a good thing to be offering these classes Equip physicians with brochures How much will it cost? Last thing you want is an unexpected bill later. Do patients quickly pay the bill?

 They can't pay it Most people don't have it The invoice looks like They think they have 4 or more boxes to go Will they come back to you if they owe you money? More likely to get sued if they owe you money It kills loyalty Healthcare sucks because they have no loyalty An industry that doesn't have loyalty is weak

 Be wary of facilities that don't make services affordable If you want more personal injury cases who should you go to? Start referring clients to lawyers Contact industrial relations in your state adjusters, docs, clinics Don't ever treat without authorization from worker's comp Do a favor for them They'll appreciate you How do you get more cash paying patients Get the message out

 You have special programs for the jobless, uninsured I like something written I don't like word of mouth We like to make these available in our lobby Be wary of clinics who don't tell you why you should come to them Offer a program that specifically meets their needs Could triple business by turning to cash programs This involves advertising principles Laser brochure makes 1 million in five years

 Go to 830laser.com Only recommend things that you use Marketing kit in a box for laser Can get screwed with HMO contracts Stay as a fee for service alternate list with hmo's How to automate your practice through your employees Hospital outpatient is good money Easier to run two facilities than to run one It's easier to run 2 or 3 clinics within 20 minutes of each other

 How would you like to run your clinic without headaches Never make a decision on the spot Should always walk away They will come back They play games You can do private contracts Contract with the miami ballet Getting injured all the time Can't afford the worker's comp payment After every game they're injured 55$ treatments

 If they wanted to try this they had to pay something for more That's cheap You super size Private contractors are nice It's good business Some of the language in the worker comp laws You're not actually doing Pt It falls under the auspices of wellness Another private contract is good Way of reducing or avoiding work comp claims and still give patients what they need

 Ptpn Pay them a lump sum and they will put you on many contracts Negotiations is not a tough thing You should have said they are screwing with me Best way to convert people Send letter of introduction Get one exposure into their brain Follow up with a phone call Follow up with face to face visit Where people are learning about you Ease the pain brochure

 Total joint replacement class Fax blasts Find a local charitable organization for abused and neglected kids Or widowers, or prisoners Develop a relationship Start donating money Give them a voucher for free treatment Everyone loves you for doing something nice for the community Get a lot of people talking about you When they do need you

 They think of your services when they need you 830 laser is a no brainer way to get on the news Someone's already done the work of establishing credibility The fax they're checking 10 times a day 20 out of a thousand will ask you to stop faxing Should you stop faxing because of the 20-30 I like it when you give me something It takes the attention off of you Mkt asst is the face of our clinic

 I was forced to do fax blasts Faxing works because they check their fax 10times a day It's good to tap into the 4% How do you get them talking Ask them I want you to know If there's a class for upper extremity that you would like to see What would you want to see Repetitive stress A class is worth $16,000 a month What is valued most by patients?

 It's what consumers value That's a commodity Back then the commodity was listen Commodity to health care consumer today is information Teaching me something I did not know There are some docs who want exclusivity Face to face with mds What topic would you want to offer to your patient Google search the doc I always like to ask them what do you dislike most about us

 When you say something to the patient that conflicts with the doc Docs hate you playing doctor Docs like legible reports that are brief They don't like check boxes How's the patient doing All they want is a simple narrative It helps to say I never play doctor You can't over educate Always say something you like about them Everyone of us has something good Be the person who notice them

 Then you have your discussion Say something good first People will do more things for you You actually acknowledge their existence Help them do their job easier Like a mileage chart for industrial med Flip charts with anatomy It's a good thing to give to referral sources It's makes Them want to work with you Docs like to know what's going on Docs love hearing from their patients

 Currently docs don't read most reports unless it's done a certain way Send a clinical note to the doc He's a miracle worker The stuff they won't say face to face It doesn't cost much money to get thank you cards You know how you feel when you get those cards from vendors Make it memorable Put their names on it Everyone signs it Mail that

 It will go along way People connect with people Special gifts Gourmet chocolates for the office managers Wine for the docs Cheap chocolates for the front desk Not a doctor who doesn't like wine Tv, radio, news It's not as hard as you think Be wary of attractive advertising Website needs to be focus group tested

 We like websites where there is movement Have a map on your referral pad The map changes everything on the referral pad Make it easy for competitors send you patients Put things outside your door so walker by's can take something Classes bring in 20% more business No consumer wants to see that This brochure helped her get healthcare practitioner of the year in the state Irs accepts up to 15% in advertising

 Put decals on your windows Laser gets rid of migraines Don't worry about food, clothing, or shelter Spend time on $300 an hour tasks I'm creating Spending time with $300 an hour tasks Do the things you enjoy The more followers you get the more successful you will become I need to disseminate information Free treatment with a revolutionary laser that's safe, fda approved, no side effects,

and will help unlock the healing power from inside your body Don't spend it till you get 3x return People don't mind paying out of pocket if they know before hand Not equipped to handle because they never got this question Who's experiencing these questions Patient advocate services One stop quick services We want to know what's really going on with our care Healthcare information You don't evaluate people

 Get rid of jargon Disconnect by using words they don't like We are glorified nurses We developed exercise skills nurses don't have Its in our roots We're very bad at telling our story, getting our message out there Sit there at the crossroads and not making a decision What happens if you stop moving Decision moves a business forward Decision is movement

 Who is capable of working with the People we work with People could care less Do you know how to express that message? They're interested because I connected with them Exciting message that people connect with We're not good with expressing our decision People don't know Don't say things that turn them off or confuse them

 What you do as a therapist You don't do ems What is it that you do as a PT Do you really take away or relieve pain? Is it you that did it? I don't feel like he cares Your job is to make people feel good You do not fix people You use revolutionary techniques that unlock the healing power from within you that produces rapid healing and pain relief Consumers want to hear this

 Does your receptionist contribute to the healing process You already feel better You're already on the road to healing How important each person is to the healing of person If you fix people you don't care about others in the clinic Goals is to get patient to say I already feel better You are using tools to unlock the healing potential And it starts with the first phone call What's you name

 Have you been here before? Welcome What happened? Did you get x rays Let me see what I can do How did I show it How did I show that I care Did you just listen to what this person told you This person is traumatized You need to get somebody that actually means it The ad you use to find this type of person

 To get them to solicit you Determining level of urgency Determine their medical urgency Between medium and a lot If someone can't sleep their healing potential can't be applied Cannot do 3 out of 5 and their pain is a medium to a lot they're urgent impaired Need to get them in right away Standard is 2 to 7 days out Everything is subjective Its like a blind date Would you like to do this again

 You can't be too available to standard patients They are not bad off It doesn't make sense You are too available I welcome them Do you want a welcome? That is what you do in the first stage of a phone call You welcome and determine medical urgency Don't be too accommodating Your goal is to get them to bring in 6 other people

 No second chance to make a good impression Everyone knows that all I do are spines Think your good at everything if you are good at one thing Is 6 to 8 minutes too much to invest in a new patient You should have music, not dead silence We'll give you a 30% discount if you pay out of pocket It sounds like a pretty bad injury but not that serious Do you have a pen handy One, got her an appointment

 Good news I have availability People think you're no different than anybody else The way you deliver is the way they take it A girl who could not stop saying sorry when she is not Getting a standard patient in 3 days is good She was costing me more money They don't bring in other people when you say words like sorry Scheduled with good news Give her options

 Automatically on their alternate list if they send someone to you HMO It's just timing You're trying to catch people at the right time Talk about payment Give them options Not trying to sell them Not saying must come in Depending on the complexity of your condition And if you require treatment and will benefit from it

 Everyone needs to hear that you could be that affordable And typically most don't require more than 6 to 8 visits If you can't get them better then there is something wrong with you Get them better in 6 to 8 visits over 60 days 3 to 4x a week is done It's more expensive with less results Work comp is 5 years behind medicare You can't eat up the benefits by doing 34x a week They say I can't come that much

 I can't afford the copay Adjust it and send the doc a note 1x a week is better than nothing Your objective is to get 6 other patients from that one patient How to think through the eval It's not if you get audited but when between 40-90 bucks Typically doesn't require more than 6-8 visits Conclude with apple We have so many controls Update their info all online

 Make appointments outside of office hours Convenience factor is significant Our documentation is audit proof Even if you miss something it will still be there We have a super control panel They're playing dirty Dirty tactics they're using to get money back Beta testing starts Jan 1st Software system I've been mapping for past 4 years Don't trust APTA products or software

 It's not for real life use Hpso is not the best one Finding an attorney who knows pt law Their meter was already at $150,000 For third day at court you should be at $14,000 Paying too much because of fear Download paperwork Payment Bring credit card, cash, or check Sending message you like money Late

 We have a strict late policy Arrive 30 minutes early No shows cost you money You should know what no shows cost you No show on first visit they're lost Typically a lost patient costs you $3,000 If you don't place importance to your slots Patients won't place importance to your slots PPO where you're in network What did I just do

 I had them call their insurance to get their deductible and co insurance Receptionist cannot be the one who delivers bad news People thing you are in cahoots with the doc, the insurance Let them get the bad news from the appropriate source Members phone number versus the provider call in number Let the patient get the bad news quickly and simply from the insurance company That's horrible What are you paying every month for Splice yourself from the bad people

 Are you undergoing financial hardship We have payment options PPO will try to steer the patient from coming to see you Two federal and two state insurance fraud laws You're the same thing but in a lesser degree They're on a religious vendetta On a religious kick Billing is an art, it's not a science Doing it for flexibility then you can bill is as ther ex

 If your doing it because they have poor proprioception then it's neuro re-ed Student PTs are dangerous They think they know because of what they learned in school PT board are not freaking cops Have to have a policy and have every employee sign it Never should not let anybody in It's a violation of your policy They take notes so they can say whatever they want Don't answer any questions without legal representation

 Its a mad witch hunt PPO out of network Call the patient Here are your options We have an affiliate who's in net work They're convenient and they're good PPO is participating provider First person who came on the block and said I'll take a discount They're going to say to their doc why did you send me there Quickest way to lose a referral source is to say we don't take that insurance

 Who do you want to preserve It sounds like a silent ppo situation They're piggy backing of someone else's fee schedule Using their provider list and agreement without a contract It's all about the physician If you don't ask you never get You have the right to get pissed off Win at first level of response Whatever they save the insurance company they get a percentage of that If you have a high deductible don't worry

 We have a program to help with financial hardship It doesn't matter where I treat at They're looking at who the provider is Make it easy for patients to get access to you Lien settlement form It's always an offer They're going to try and intimidate you Attorneys lie all the time They've come to a resolve It's not who I am It's what I do

 That's how they justify lying How do you respond to that Thank you for bringing this to my attention Is your client aware you're talking to me like this I'm going to take your client to court Because you're being really offensive to me Cash low income Cash high income Can you tell me more about your program Tell me what's wrong

 The price will depend on the complexity of your situation Don't go into explaining Are you unlocking the healing potential inside me People want to pay for feeling better Are you unlocking the healing potential inside of me It's not by chance they know how to make $26 million a year They use the art of war to train CEO One of the tactics is divide and conquer Another tactic is to confuse them

 I'm showing compassion to them by just talking to them Show prejudice by the late filing Lost money because of the late filing Show they were prejudiced by it Bethesda naval research on cold laser Accelerates spinal cord healing 6 to 8x No thermal effects It's not common sense Paycycle.com for payroll Where your trying to go and how you walk away

 Once you define that we help you accomplish that How do you walk away Don't give people reason not to remember you PT is something you take control of Will a person get better if they spend less than 2% of their time getting better? Important to acknowledge that's horrible Why is it important to put in time to train your receptionist Your receptionist can ruin it for you Intake

 How your front desk handles the intake will dictate the relationship with that patient for life A female, a gay guy or a left handed person Straight guys don't have communication between the two hemispheres Straight guys can only do one thing at one time Who you should get as a receptionist Main job of receptionist is to gain loyalty of patients Most receptionist hold the clinic hostage That receptionist literally runs the place When I walk into a suffering practice they don't greet me

 They take too long scheduling one person Your receptionist should never schedule more than 2 or 3 appointments in advance Your receptionist can't do their job until you create an environment so they can do their job Why is that cash register here? Where are the forms It's not about hiring great people to build a great business It's about building a great business to make a great people Our organization is a stepping stone to something better

 It was me who was stupid Until I made the position right even the perfect person would fail How did I contribute to that mistake You will be a different kind of captain Your chance of having a successful business will be higher If you're going to make it easy for people to do the wrong thing Even the president will do the wrong thing if you make it easy enough It's how you do it that makes a world of difference When you have a loyal patient they will bring people in

 How to streamline your front desk Training the receptionist Train how to greet Stop what your doing Nothing is more important than that person walking through that door Look people in the eyes There's something about looking people in the eye Make eye contact Say hello welcome Smile when you welcome them Use their name

 Say their name Don't look busy You have to explain what it means to perform People don't like being told to be fake Screw you I'm not going to be fake for no one I expect you to perform You're going to succeed What does performance mean It means What type of people do you know who perform

 Fake it Make it look so easy You could not tell You would not know Performance has nothing to do with daily tasks Hungry, headache, hung over I don't want to know Patients don't want to know That's performance I expect you to perform Once they understand it they will do it

 It's so hard to decondition and recondition Should they do this with you? They better There better not be a time where you don't greet me the same way I better not walk in and have a day that you don't do that You have to smile Employees come in sick There is no incentive to be sick My staff prefer to come in Sleep when it's down Time

 We love them more for what they did Let us send you home If they do it once, you forgive You need to control your life What should we do with your work load? Now it's culture You need to get culture It's ok this one time Tell them you don't want them to do it again Communicate by telling them Your the one not equipping the staff to schedule themselves

 I do recommend that the receptionist position is split into 2 part timers How do you feel about it What do you like about it Sign in Please ask for the receipt so receptionist can't pocket cash #1 patients hate to wait #2 patients hate paperwork Express Registration form Hippa notice Pre exam form What do you feel about these rules

 People give you opportunities to see who they are Some business cost you money and is not worth it Assignment of benefit - any third party Advanced beneficiary notice - Medicare only Lien form Payment worksheet - work comp People give you opportunities to see who they are AOB is a legal document Don't give patients reasons to hate you

 Important policy poster with someone smiling Is that important $10 fee, people consider it fair Second sign they should see Don't break the law poster Can't waive co pays and deductibles Professional courtesy is not acceptable Every doctor's office should have a don't break the law poster Tell me 4 things in how to train a receptionist to greet Most powerful tool for receptionist

 Clearly know what the rules are Rules are not meant to justify punishment They are opportunities to exercise compassion and forgiveness If someone doesn't know they did something wrong there is no room for compassion or forgiveness They are ready to pay once they know the rules There is nothing that can't be forgiven once Inspires and creates loyalty through forgiveness Seen how her forgiveness and compassion has power

 How strong a person has to be to forgive You clearly define your expectations and rules And you expect them to be broken Prepare to respond with compassion and forgiveness Able to go against everything you believe and do this in faith the relationship becomes stronger They just love you You can do all these things you think are going to make your patients happy and tell their friends about you Being forgiven is a big deal Some people have never been forgiven

 It's something magical It changes relationship The walls in your office are billboard space not art space People get better faster if they pay a little bit as they go How to use a fee slip Video tutorial 3 part NCR form Secret tool to collecting as you go Medicare has an 8 minute rule Just practice the way you think you should practice

 PPU price per unit Not writing code in here ever in fee slip Have to put down how much you did If you do not give them a bill that makes sense and they can understand They won't want to pay it Round up on fee slip so you can send a refund check later on It's hard to compete with an indefree practice Got to get that patient hating their insurance and loving you What the hell do you pay every month for?

 Ask a question Are you undergoing any financial hardship? You never say, well that's our policy They don't complain any more They don't hate you because you were being helpful and professional Determine exactly what they are going to need How important is this to you? Do you trust me? Right from the get go we give them payment options Make a good faith effort in collecting

 That's reasonable to say old debts.com Sending invoices is not goo faith enough anymore You're not getting a tax break by writing it off What to say if that ppo is out of network What does the receptionist do What are the options for ppo Sometimes your activation is going to miss this is out of network Get the benefits Give them options

 Show it to the patient Pay out of pocket and get 30% discount Don't want them going back to the doctor complaining you don't accept their insurance No problem, fill this out As they fill it out what will they learn? They will have to pay an extension fee if they want to be treated There's something amazing when you're forgiven Very rarely in our society do we feel forgiveness What do you ask?

 If you qualify we can help We can waive it It's important to let people know you have a payment plan So they can bring in friends and family who have financial hardship What are the options for an hmo? They're not coming to you Help you submit a request to see us To get on the alternate list for the next 10 years We can help you submit a request to be seen by us It's in your best interest

 There's no deductible in hmo More people choose hmo You want to get on an alternate list with an hmo Medicare is handing patients over to hmo Get as many people as you can to come see you How to handle confrontation correctly Stop playing doctor, that's a confrontation How do you handle that Being what I'm being Confrontation equals an opportunity to make things better

 If you respond appropriately you can have a better relationship You better be careful what you are asking for If you say get the hell off my back What's the opposite of love Indifference is when you stop caring He's not worth it Love dies You can't get it back How do you respond? What's the first step Thank you so much for letting me know

 And giving me a chance to respond Hold on just a moment Pause Leave them with the thank you Step away take a breath Come back Ask the best question you can think of What's wrong How can I help Would you like me to do this anyways Think of a question to ask to get them talking

 Suppress your need to talk and listen to them Shut up and listened How can I help make this right What would you like me to do? You got it Anything else? Family or friend is accusing you Hardest thing to say is how can I make this better So hard to get out of your mouth What can I do to make this right? Don't try to justify you were right

 Feel so small for being that way to people I love Need to be so right James you could be wrong I don't need to be right What I need is to be loved I would rather be loved than be right any day This is how you grow the relationship your in You will experience a totally different path than your living I'm sorry is very appropriate

 I'm willing to give you what I want just so I don't feel hatred for you A lot of people feel unmotivated because they feel uncomfortable feeling hatred toward someone Most you can do is apologize and make up doubly for it You don't get many chances to make relationships grow Got to set your fees appropriately There's a critical price point that will bring you the most business The way you set your fees There is no magic formula What would you pay?

 Be above medicare rates People will look at that and say that's fair They have no qualms paying it Automatic 5 minute foot pressure point release I don't know what you're putting into it Times it by 1.5 Make sure that fee is higher than medicare's fee I guarantee you you're never going to fall below medicare rates It's only $105 for Initial evaluation You could use our fees and do well anywhere in the country

 30% is only to those you are not dealing with their insurance company Ther exercise is one on one There is some skilled intervention Intervening with some skill If your using an aide I would charge half that I don't know why you are not intervening It's really up to your interpretation and your intention in that manner He's not just an aide He's a tech 2 If he challenged the pta board and he would probably pass

 You can make money with laser by billing the work insurance Super bills, they don't work 3 part fee slip 59 think of it being distinct The unbundling code How long are you in that eval face to face determining what's wrong? What do you bill? Eval is not a time based code If a patient has bee told they have this condition, that's a diagnosis 97001 eval

 $190 total Doesn't sound right because it's not right Ther ex is a time based code Different body part Different diagnosis Two different systems that are problematic If this is a medicare patient your going to reach the cap very quickly Typically unlikely your going to use the 59 without the 52 Use the 52 occasionally You could be red flaGged for only using the 59

 You should always charge for what you did If you do something you had better charge It had better reflect accurately You could be charged with fraud What are you telling me? Do you deserve to get paid for those treatments and the eval? Rebill it with the 59 mod on your eval and treatment The reason why you don't get paid for reeval is because you don't put the 59 mod on it If it's not written it doesn't exist

 Be artistic Find a different way I need to know more You have to do re-evals per state practice act Re eval is as much skilled eval Start using codes that pay more They should be thinking how do I make 30% more Add 2 things Make sure you have one comparable sign that is functional Stability during walking 50% safe

 Each time they come in increase it by 5% Make yourself safer and start using a better code Seniors don't need flexibility Seniors need functional ability 97140 for decreasing pain It's a tough thing to bridge manual therapy to functionality improvement 97530 does pay 30% more than 97110 ther ex Bill under 97039 as unlisted item or modality What's serial casting?

 I have a feeling your not maximizing your reimbursement 97039 is not a time based code Non time based codes vs time based codes Always talk to you payor and know their review policies You should know what you agree too When eval a d/c patient use modifiers 50 mod is bilateral code Don't need to use or know other modifiers Don't go overboard with 59 modifier without the 52

 Everyone in this game knows what 50 modifier is You are safe if ever audited They're using this as an excuse to get money back They're winning fraud cases with that They just want money from you You're billing for treatment that the patient is not able to participate in Don't say tolerated treatment well It means nothing Put down patient participated well in treatment today That will save you in court

 There is no proof of escalation Always sign your first, last name, and title Make sure your getting an md to sign off on a plan of care Make sure your status note is signed by a physician Everything is a good faith effort No one is going to blame you for not being able to control someone else's problem Have you noticed the change I plan of care being faxed by inde fax We give them what they want to see All of you should outsource your billing and focus on bringing in more business

 Spending energy to collect just a little bit more is like clipping coupons Focus on bringing new business through the door See physicaltherapybilling.com The source of needing or feeling that your always right comes from an inability to deal with the emotion of hatred or the denial thereof The denial of hatred can blind you the Possibility of being wrong You think you are right because you don't believe you are capable of hatred Hatred cures your need to be right Need to be loved the most whe you feel intense hatred

 Hate is the right you can't feel when you think it's wrong Steps in getting short listed Keep track of claims not paid At 30 days initiate action ID poor language in EOB Hold them accountable to timeliness law Appeal every denial Pay you just enough so you think there isn't an issue Appeal every time they deny you You respond This is how you win denials

 Your fees are excessive Everything I bill I pay Exceeds fee schedule for customary and usual A letter you give to your patient, the insurance company, and the insurance commissioner Without an explanation This interferes with my relationship If you want that patient coming back If you want that patient sending other patients They will keep doing it until you stop them

 If it's too thick throw it away Hatred is the greatest motivation for the common man 30 days You have not gotten an eob letter Your tenacity is what gets you short listed Report you for violating prompt payment laws Please be cognizant of the time line You may be reported to...as a delinquent insurer Patient initiated complaint Hatred is a most decisive factor

 He didn't become a good decision maker until he could admit to himself that he felt hatred Referee between david and goliath Otherwise goliath would run amok $30 request fee Way to say don't screw with me That's find don't pay me I'm going after your member Appeal every denial/reduction Denial because it wasn't medically necessary Patient ineligible

 Filed too late Benefits exhausted None of these are valid denials Interferes with the patient therapist relationship I know how to make decisions because now I know how to feel hatred Feeling hatred is the only remedy against being in a false sense of being right You cover your inability to admit you were wrong by pretending not to hate in order to make yourself right Fees are not customary and reasonable I never agreed to a reduction with you

 We cannot control their response We're going to go after your member That's when they pay you We don't like confrontation You have to play the game That's the only game they respond to We're all cut from the same cloth We all want a zen life When I send this to attorneys they pay up Are you having any issues collecting from medicare? Download the medicare software

 Do not even be remotely tempted to do your billing They can't charge until you get the check Don't make that mistake You focus on bringing money through the door Hating something made me good Loving something made me right What are you trying to build and how do you walk away You can't make decisions You don't know where you want to take it You can always change your mind later

 Before you take steps Before you take actions Make a decision now before you start taking action or steps You are the cream of the crop because you made a decision to be here You went into this because of the cush hours and having a job wherever you go Get to make your money and go home and raise your children Try to give back to our profession because it's a privilege Don't have the resources and the where withal to fight back Your benefiting by these people's suffering

 Don't keep taking without giving back They just take They bad mouth employer They get to go home with their money They could give a damn about our profession Clarify the rules and expect that they will be broken Training the receptionist is the $300 an hour jobs Structuring your front desk Training your receptionist What is automation?

 Do you want it, what is it you want? Do you want to be able to take a vacation? When your not there, do you want it to actually grow? How do you make that happen? Automation is having your business grow without having you be there If you don't do it that day, that's a fire It's their job When they're getting paid to do it , they actually do it and do it better You have to pay a marketing asst to expose your message to the community

 20 hours a week Someone is spending 80 hours a month getting your promotions out there, will you make back $3000 dollars? Make over $1200 a month with the laser Potentially bring you back more than $3000 a month If you don't spend you won't grow You have to go to him because he has an amazing laser Spend money on those things that generates new business for you You have to go to him because he has that Stop putting out fires

 Anything that has to be done Pay someone else to do it They make sure there is someone who can What's the definition of automation in private practice Increasing profits without you being there Making more money Producing more patients I do it when I feel like it Share with you what I do How is it I don't have to step foot in my practice and it grows

 The number one thing that gets in the way of a business growing is the owner The owner gets in the way of the success of the business Automation is not having to be there And there is a high perceived quality Is there perceived quality of care if the patient is not getting better? You think high quality is a certain thing in your head High quality is a perception Its the patients perception How to increase their perception of perceived value, not yours

 You want a clinic full of people who think you are the best Already feel better because that healing power is already unlocking Already feel better Placebo effect 51% That's how powerful the healing power is Address their perception It's 51% effective They're already getting better Not allowing that 51% Phases of automation

 Everyday I get a one page report I scan it in 2 seconds and I'm done Form takes 2 minutes to complete I look for trends I hate no shows What's your threshhold? Zero is not realistic Living your life like a scrooge Always unhappy 3% no show Are no shows a reflection of something?

 It's a reflection that your is not doing their job of addressing loyalty If they go above 3% I send them a memo Stop it Stop what you're doing What does it mean? What does a crew have to do to decrease no shows It's not common sense Most practices try reminder calls Your relationship with your patients are like blind dates

 Next week Sure It's just a little weird when you call back to remind someone I'm not calling anybody How do I relate to them in such a way that they value this so much I don't have to be the one calling You should not ignore your body, your spirit trying to tell you something It's trying to tell you there's a better way Don't try to brush it away Think of a better way because there is

 How can I make the interaction so valuable that they come no matter what What's wrong? Is your pain medium, a little, or a lot Are you having trouble eating, sleeping,walking, going to the bathroom I reserved this spot for you No shows are directly correlative to eye contact The eyes are the window to the soul Smile If your staff are not smiling no shows will increase

 No one likes to walk into a room of frowns Say their name 3 times They will subconsciously or consciously forget that appointment to avoid that frowning face Give your attention to the patient You've got to give them your full attention Learn how to control the conversation Clinical staff has to ask them show me what your doing at home Ok start doing it They spit it out

 There's no hesitation Accountability decreases no shows If you don't ask them regularly they don't see the value of coming to see you If you don't do comparable signs no shows will increase What are you doing at home Stop doing that one Start doing it that way Reach up Stop There is a 3 inch deficit Its a sign you compare every treatment

 If patient don't see with strong evidence they are getting better each time perceived value will decrease They can't feel improvement Went way beyond their critical dc visit How do you feel about your improvement? No shows increase, stop it They know what that means They can't lie It's all online I can jump online and see what they are seeing 5 stages of automation

 This is what I do that allows me not to step foot in the clinic You have to be ready to receive it First step is self You have to become a person ready for that Need special tools to automate Take away the tool it's nearly impossible to do the task Third, is the physical environment Physical environment has to be set up properly So congested So many things are missing

 It's a science It is not an art It's not just preference The way your physical environment is set up can lead to failure How do you feel about that change Certain procedures have to be in place Employees have to take ownership What has to take place before employees can take ownership Before they can own it you have to give it over Did you give it?

 Did you let it go and give it to them? They can't take it unless you give it They want to control it yet they want their employees to take it over You have to first work on yourself You must desire independence What do you think I mean by that There are people who need to be needed Want other people to depend on them Are you one of those people wanting to be mother hen They don't need me and be ok

 Some people create an environment where every one is coming to you with their problems Got to stop your dependence on other people needing you People depending on you is not what gives meaning and purpose in your life It's not as easy as you think They don't need you You need to substitute Once your staff and clinic don't need you Got to start doing these other thing and start to substitute Stepping up and say I want to lead

 Have to embrace what your role is Think of yourself as the head of the body The receptionist is the heart The therapist is an extremity You need to be the head The head only has two primary functions Package programs Create tag lines Writing articles Trained what to do with that business Getting a message out there

 Have to apply things you never applied before Have to become a mountain mover that finishes what they start One stone at a time Got to be a person who doesn't get over whelmed by the mountain That's the first step Can't go onto the next step until you prepare yourself If I feel it, the patients feel it too Like to use my website for a team hub What they agree to is what they agree to Do we always make them wait?

 I like making people happy I used to be the kind of person who would disappoint I want to over deliver I want to make people happy How much money did I bring in How much expense was there Calculate what your expenses are for each month so you can make decisions Complaining is grounds for termination I'm so tired Is that a complaint? Oh, I'm hungry

 That's a complaint Can't go I'm hungry Grounds for termination Can you watch the front so I can lay down Do you mind grabbing me a snack Have to tell your staff what is a complaint and what it's not Bad mouthing patients, you're terminated Paid time off is paid vacation pay Vacation is only for licensed employees Earn vacation pay based on the hours they work

 Get 3 hours for every 40 hours worked Do not pay salary to anyone It's the easiest way to make staff do the wrong thing When you fire them the write up is important Need justification for firing due to violation of policy Warning for first offense Write up Suspension If someone complains we can fire them on the spot Complaining is that damaging

 Make patients feel like staff need to be taken care of Went into business to build the kind of house you want How did you respond What documentation did you provide when you responded I have to see what you offered That's what people do, they're just dishonest I want them to think through their own decision making process That's why I respond to a question with a question You're trying to build rather than be the building

 I like to use videos to train staff Daily productivity sheet How much revenue did I generate today Only certain things you must know Who generated it What was the productivity of the staff there I shoot for 40% profit Who generated $3000 day I don't over pay myself I can out money anytime I want as an S corp People are familiar with corporation vs llc

 Pay myself a standard rate so I can avoid paying higher employee tax I never knew where I was in my day to day Quarterly P and L was hard to make decisions They cannot know what someone gets paid They can't even try to inquire about it It's grounds for termination Late policy Goes both ways Need to track that Receptionist controls the flow

 Patients hate most is waiting Who is responsible if that timeliness mark is on the rise Who is responsible? Who do you punish? The receptionist is responsible ultimately Receptionist is the patient advocate Her ass is on the line If he doesn't listen you write him up If you get me involved something is going to happen Are you ready for me to get involved I investigate to see who's at fault

 The licensed professional needs to take control I will tell you what punishments you can do How to punish them is revolutionary You would never think of doing and it works The future is going where you don't use fax machines Xerox documate Best high speed scanner for that price Human resource officer documents people who are late What could she have done to not get fired

 It's not your mistake that gets you fired There is no mistakes that an employee can make that is near the size of the mistakes that I can make that would cost this business the most If you sit there and act like there's nothing wrong, you're fired Their coworker was trying Determine how people are responding to this problem Who knows the story well, tell us the story It's your response that will determine the outcome We take accountability for our mistakes and our actions

 You will wish you fired her 6 months ago Either sign it or your fired Need to do some investigation How do you track employee hours It's so easy to do the wrong thing Employee punch clock www.veritasksoftware.com What I'm telling you You would not find on your own $269 one fingerprint device and up to 10 employees Just a one time fee

 One per location Get your money back in just a few months High return on it's value Saw a 15% decrease in payroll Only receptionist can clock in early and late Everyone is from 8 to 5 Receptionist is such an important employee The moment she does something wrong That position is tainted Person will live with a grey cloud over their head and your business will suffer

 They're going to fall because you fall Employees cannot become your friends or your family Don't hire friends or families unless you create an expectation of rules Failing relationship Define roles, rules, and punishment It's never too late to clarify expectations and set up rules All monies lead to me Do you want your daily closings to sit in your practice till the end of the week I don't like money sitting around It's not a fire I want to create in my life

 They put the money, checks, and credit card receipts into a priority envelope and sent to me All I take is the cash I'm just sharing with you what I do www.nurol.com Retail point of sale system that is very affordable You need to collect at the time of service Can't take the copay, ring it up, and pocket the cash Indeoffice free for 3 years with partnership package Some kind of collection system

 It's too easy to do the wrong thing Why should I do business with me? Are you sure that's what people want Have you surveyed people to know what it is they want We know what it is that people want in choosing a therapy center This is not common sense What it is people want That will determine whether people will do business with you Convenience in location, payment, working with you, payment options

 The office that can offer patients convenience will be successful The office that can advertise you are the most convenient will get the business The one who offers the convenience will get the business Convenience is a part of retention and loyalty 3 part NCR forms Save time, save money Physical environment Front desk Where they do not have faxes coming in or so many calls coming in

 Any reason why the receptionist have to see the mail? I want to see the technical start up steps class online Give it to you guys for free Your going to see how to set up the system You should not have mail coming into the office No mail goes to the receptionist They can hold you hostage because they know everything No way a receptionist can invest 6 to 8 minutes with a prospective caller She only handles returning patients

 Activation person can also be your personal asst On appt card it says call this number to schedule or cancel appointments Can I call you right back Can't do that to a perspective client The internet number for a new prospective patient Instead of a fax line Go to my fax.com and get a fax number What are they doing? Building loyalty Your creating an environment for the receptionist to do her job

 Do you want more peopLe to bring in family and friends There are no limits if you change to this system Should you have a gym? Yes A 12x12 sized gym Put bins where you put the chart No system ready yet The future in healthcare is all electronic A charting counter No such thing as an office for your PT PT don't need an office

 Unless you want to sit in your clinic don't have an office On that charting what do you want to have Computer Bins Charts that might be dc Charts that need to be signed Charts that need to be filed Icd9 list laminated PDF version of this Why do you like to have those there? Have to determine icd 9 codes

 One computer for every PT On computer for admin asst One computer for billing liaison One computer for aides and techs Don't do billing in house until you automate your patients Do not have to input billing data anymore That's what makes indeoffice so revolutionary It is going to recommend the appropriate appeal form if something gets denied I want you to walk into your office and tape a path that a typical patient would walk

 Make sure there is a flow, a path Make sure that path is not blocked People don't want to sit in your place for 30 mins Create this fl1400-1600 sq ft is ideal Pony walls Do not put walls that go all the way to the ceilings Put plant and flowers on the pony walls 6 by 8 foot tx room Do not use curtains Make your office look nice

 Throw a pony wall to cover behind the receptionist wall Her front office was like the lapd No more them and us feeling Now its a we feeling I want my mom to experience this place Your physical environment contributes to that What charity are you going to contribute to Bring some canned food good because they're helping abused and neglected kids Half the battle in owning your area is getting people to know who you are and where you are

 How to streamline your documentation If your documentation is not designed well your employees will hate you Staying connected after discharge A patient who's already come to you cost much less, will spend 3x more money than someone who is new More likely to listen to you and do what you tell them to do Have a marketing asst in their job description say you must send birthday cards Why a postcard vs a card Sometimes your the only one who sent a card

 Have to give an email to create an account Have an email to send automated newsletters related to the diagnosis News, facts, promotions about low back issues Can forward to family and friends You make them a discharge patient they will get twice a month a newsletter pertaining to their diagnosis That way you stay connected Staying connected to reactivate, to get them back in What's the best way to urge them to come in Just an important reminder

 Your benefits are going to renew Your deductible is going to renew If you have needs this is the time to take care of it If you have already met your deductible Have patient appreciation day Get their spine screened Free laser treatment So easy to give away free Two cycles of 40 seconds Many patients in just over two minutes get better Put an x x with a pen and the aides do it

 Migraine pain relief in as little as 6 minutes Shoulder joint replacements facts and answers, myths They're going to spend their time doing this stuff Marketing asst success kit A kit on how to manage, train, and oversee your marketing asst Administrative support procedures Administrative Supply ordering Best way is to throw away quick books I threw away quick books and my life changed

 Let the accountant reconcile my bank statements and categorize my expenses Tendency to not change it Their liable if they change it Do not have a paid employee to do your book keeping I don't like anyone who does my payroll and books to interact with my employees $3000 a year my way That's fair Don't do the work of categorizing your expense Pay to not have to think about it The worst part is year end stuff and taxes

 Should have an admin/personal asst So they can stand in line, post payments Why do you want to invest in someone else If you don't have that person who's going to do it? Then you can't do the other important tasks that would help you grow your business Try not to use independent contractors Employee point system Anywhere from $100 to $2000 dollar per employee Its a performance pool

 Exceed that threshold as a team We keep a team lates and tardies The whole team loses points Its performance money Less money to go to their bonuses We don't like what your doing because your costing me money Creative care service Anything is possible Doing the right thing creates opportunities to be forgiven If you do the right thing you'll have an opportunity to be forgiven

 Set up your own transport service I'll add points So their pool will increase It's a team that can increase the amount That's how you build a team The team will let them know stop screwing up I want to be loved I'm no longer the bad guy Your still the bad guy If I walk in and a policy is being broken the team loses points Should have job descriptions

 It could save you in court Whether or not their employee is competent with what you have delegated to them Compentancy to render it You are negligent if you assigned a task to someone who is not competent Prove it How do I prove it If its not written it doesn't exist Trained on the most common diagnosis, treatments, procedures Levels of competency Tech II is almost PT asst level

 In CA aides can do suboccipital release and pressure point release An aide II would be good with locating and assessing tissue Tech II would be highly aware of any irritability Different levels and different skills Were they being supervised? Were they competent in what they're doing Prove it I'm not the appropriate resource In order to be loved you have to be hated First 30 minutes of every monday

 Poor response during words of wisdom is a red flag for potential problems Positive quote Talk about what that positive quote means to you Don't be short sighted Every other Wednesday they must eat lunch together and train We don't do monthly stats meeting We just post it up How many were brought back 10 minutes late We are only allotting 3 or 4% of the time to train

 You don't have the right to say what the hell are you doing without training them first After 50 appointments a week the receptionist is no longer the activation specialist Personal asst can also be a admin asst After 6 weeks need a ft marketing asst to sustain 200 patients a week Just become better where there is no pie We put you in touch we people A collaborative effort is so nice Don't burn bridges All we're trying to do is make our profession better

 Through the patient perception What does clinical excellence mean? Doesn't seems like he cares Being good with your hands Is that clinical excellence? Is that important? If a patient doesn't want to be treated by you Does that define clinical excellence Patient's perception They go out and tell everybody how good you are and bring in people to you What is that?

 They can't physically improve but they bring in everyone to you What is that you do? Uncanny how everyone responds We promote life. To those who need it most We use revolutionary techniques and treatment that most patients love That unlocks the healing power And speeds healing and pain relief Our patients love it and so will you They want to pay for that

 They don't want to pay for ems, massage, exercises Don't tell them things they don't want to pay for To unlock the healing power from within That speeds healing and pain relief Does your receptionist contribute to clinical excellence? Yes Your biller, your aides, all contribute to clinical excellence They can't get new patients to come back because they don't have clinical excellence Part of clinical excellence is that I have to train people

 It starts with you offering revolutionary techniques that unlocks the healing power from within Care that inspires patients to bring in another patient New grads can have clinical excellence Anyone can have it if they know what it is Have to get away from the notion that money and wealth is only reserved for the elite You can have it right now You don't need to wait Keep remembering what it is Training your staff on what it is we do

 Those are our tools Ems What we do as a team is we do is revolutionary treatments and techniques Move forward with training your staff I can contribute to that clinical excellence Because they have already started the healing process and they haven't even met you yet The receptionist continues the healing process by how they speak to the patient How many have brought in another patient in the past 30 days Getting the patient to bring in another patient

 They know what you do A part of clinical excellence is them knowing what you treat Its you communicating with the patient and they knowing what you do You can do this now What are you doing about it Exam Can you the therapist blow it when everyone else is doing their job You need to continue to unlock the healing power Need to sit down Need to make eye contact

 Look at the person and say tell me what's wrong Say their name If you're not doing this you're not going to preserve the perception of caring In their mind are literally saying Would it kill you to acknowledge as a human being. I can't live my life the way I want to live it What we're working with is the most exciting profession Sit there and act like your burned out Love what you do And have clinical excellence

 Or just punch a clock Don't act busy Don't have anything in your hands Be with you in a minute Does that unlock the healing potential? No It's really the receptionist that sucks A lot of therapists suck too CD with clinical tools and documents and videos I want to know if you disagree I don't know how your going to lose it So many things take you away

 You must start implementing That's the only way to keep it alive I'm gonna make this one change in my clinical practice Most people can't implement through 3 We don't learn well through reading or watching videos We learn through interacting Is she getting closer and closer to her dream? Yes They're jealous that's why they keep trying to dog me Decondition and recondition by applying it every day

 Elevate to a new level Doesn't happen one time Have to be repeated exposure to change Don't let sss kill you Follow through and complete just one thing Do one thing and implement it It's not what you say or do but how you make one feel that matters most Personal mission statement It's a guiding light on the road of life Someone wrongs you Those are storms

 You bounce a check Your response defines you Come towards the light I will keep you safe It's how you make a patient feel that matters most Caged birds don't sing Mya Angelo, author Keep that as a forefront of your thought You'll still have this beacon of light come in the store And sit down and look the patient in the eye

 Pre exam form Must profile the patient Whoever makes me feel forgiven will have my gratitude I'm not trying to teach you anything I want to see the pre exam form first Rehab potential Think about why Correct answer was excellent Think about why you said good Now what you just did is profile This is an important phase

 When you meet them face to face They suck you in and confuse you What you did You profiled Chronic pain Obesity These are all limiting factors Only limiting factor is lack of motivation I want you to write this down Don't lift anything over 30 pounds If you have something in your hands don't twist

 Every 30 minutes get up and stretch Show them things to self manage at home Unable to control those self destructive forces Rehab potential is poor I'm not going to help fred, he doesn't want it You just profiled motivation This is an excellent patient because they are so motivated Same Worse Instead of ice we're going to do us

 Next time she comes in you feel disgusted If you identify that she is poor You can flip her to excellent Tell me what's wrong Tell me what's going on Let's find somebody you can talk to I feel better It's not your techniques that get them better Care that acknowledges somebody's existence or problems How do I motivate this person to really get better

 Don't lose sight of that You know what happens to fred, who has no motivation When does his pain come back Two hours later When fred goes back to see the doctor Shadow 2 hours once a week Seen many freds come into a docs office How's therapy going What's fred saying It helps a little bit and then it comes back Doc thinks fred seems motivated

 What's wrong with the therapist That's why your benign to docs Doc thinks you are benign Can't even get a motivated patient better Do you not know that the world thinks you are benign Do you not know that? You don't feel quite like you make them proud What you do is considered to the world as benign Here's the thing We do care what people think

 You don't want it to degrade or detriment you Don't stop caring and decreasing your self worth Start doing things differently No excitement Can't get the patient better Let fred go Come back when you can follow directions Make failure not be an option Trust your instincts right off the bat Keeping in mind that important thought

 Is this person motivated Smallest little thing make it worse Can't identify it Motivated people are trying to attack it They're really trying to understand it Need to find out why Your job is to start asking questions and determine what Is going on Do you really want to take this seriously Do you want to make this problem a priority You will get an answer that tells you

 How many hours a week are you willing to put towards getting better Spending less than 3% Unmotivated person will not do things on their own You need to become a practice that is not benign If they don't fit into the program You got to preempt that with a note to the doc He's a mechanic The disruptive forces he's not able to remove or change He's not appropriate for us

 The doc is going to get that Now you can do the assessment Determine the structure at fault Determine the motivational level What the hell are you writing down You don't even know what is wrong Why are you writing baseline data Wastes time and confuses you Won't help you in court Not in alignment with what's at fault Still don't know what's wrong

 This stuff isn't going to tell me much about a disc protrusion L4,5 disc protrusion Go straight into assessment Validate your assessment Do some slump testing Check reflexes Check myotome To confirm your assessment Don't worry about baseline data Squat on your heels Squat is my baseline data

 How far his buttocks can get to the ground Functional baseline data Functional comparable signs Baseline rom won't help you in court Showing the person is able to squat better, deeper, with more control, with more strength Where is it written How did the person functionally get better Can't prove the treatments were medically necessary That's fraud

 What they're trying to do is unfair and unjust A witch on a witch hunt Your documentation doesn't validate it was medically necessary Doing it just for the money Even though they don't get better There's no standardized documentation There's nothing that says this is the standard for documentation No standardized requirements Squat is one comparable sign Transfer mobility issues

 Science is not common sense Art is common sense Pain started at 25% of movement Baseline data has to be functional Establish functional baseline data Minimum two functional baseline data Why we said to do comparable sign If they're not motivated they will no show Make eye contact Decrease no shows Aren't you going to check Don't skip those corners

 Single knee and jump Star Back and forth Contralateral side Do's and don't s Give them a handout Fred write this down Don't lift 30 pounds Don't twist if something is in your hands Don't hold you breath when your on the toilet Don't sit for 30 minutes

 Keep that belly button pulled in Engage the piss muscles Hold for 10 seconds Engage your groin muscles Weak pelvic floor muscles contribute to L4,5 disc problems How many times should you do it The greatest skill bar none a therapist can have is: To get the patient to do what they are supposed to do It is a skill Show them one exercise

 Make sure he remembers it How many times to do it Twice Morning and evening Don't tell them 3x unless they're retired Almost everyone can do things twice a day Anything more than two they fail When they fail they close up their healing powers Do's don't's, exercise prescription Frequency

 Do not want to pull out that white model with the vertebrae Fred what are those? These are lay people Fred is googling On diagnostic what does it say You need an MRI Docs are not stupid You think you're the only one who knows how to do a slump test No saddle region problems Doc puts low back pain instead of disc protrusion

 Takes you 6 months before you realize you lost the referral source She's trained If you like it stop playing doctor This is the way doctors are What is confrontation An opportunity to create a better relationship If james is yelling at you then you're good When he stops talking to you he's separating himself from you Do not over educate Do not over educate

 Quickest way to lose referral sources Has some spondylosis going on I'm going to fine tune Icd9 coding is an art Find 2 that you want to use Minimum 2 icd9 codes per patient Every icd9 codes has a group of cpt codes that is logical There's always some that is not in the others Need to cover the icd9 code Train your therapist to choose diagnosis Define roles

 My job is to be sure you know how to control your pain The moment your not willing to do your job I can't do my job Have to start getting patients better or else your reimbursement is going to go down If you know what your doing and do it well You're going to survive When she was let go personalities that were repressed were let out Sunshine I was so happy when she left You will not get the results that I get until you are doing it well

 If their LBP is not going away in 2-3 treatments then you are not doing it right Listen to what I'm not saying They will get better Talking about me wherever I go and brought me patients The psoas release wins people over It's a big part of loyalty If you don't remember your personal Mission statements, it's of no use to you Making that person feel like your really sorry Do you ever have days where you want to have freedom

 Things you should not do Things you should do Most PTs do exams like they do in school which is not real life And one exercise Losing more people than you know The objective of your exam is for them to come up to you and say I feel like I'm already getting better That's the goal of your exam You want them to allude to thank you I'm already feeling better The controlling destructive forces phase should be done in 2 weeks

 Controlling destructive forces last 2 weeks You don't know what's wrong When you know what's wrong, it flows out very easily Do mindless repetitive things, my mind is burned out How many times you want to see them before you progress, change, or dc them The model of rehab is changing today What's a patient code Extended, brief, intermediate,comprehensive Brief is a hi bye

 Seeing my aide for the majority of the treatment Some laser or STM Check comparable signs and say bye Face to face 10 minutes only from me, that's intermediate Pt only part Work on patient for 10 minute Extended is face to face for 20 minutes Comprehensive is where I'm spending 30-40 minutes with one person Never spend more than 30-40 minutes Your so close but you're not opening the box

 Most PTs actually have it backwards Most PTs believe higher quality of care means spending more time Quality is time based Quality is based on time the other way The more time you spend with somebody the more quality you have to inject into it or else you dilute it It's time based I want to continually send a message to the patient I'm telling and teaching them what to do at home James was telling me the truth that he's going to teach me and there are some things I can only do at the clinic

 7/10 patients are a hi bye Point value of one Every appointment slot is available Every practice is losing 30% of their business and they don't even know about it The easy ones are the ones your losing I don't really need to be here They need more convenience than mrs jones If he doesn't get a convenient appointment he's not coming That worker's comp plan is following medicare guidelines

 Medicare want codes that are one on one I don't follow time based code rule with medicare patients I can get patients better in 3 minutes Are you saying I don't deserve to get paid I'm going to treat medicare my way Productivity for medicare for patients is always low It's an art not a science That law is so full of holes, so broad they don't have a leg to stand on A point of 4 they can never get double booked So comprehensive stays comprehensive

 I'm going to make you a vip, your now a 1 I do not like looking at a computer screen in the clinic You practice this way Indeoffice will help increase profit by 30% by preventing people from falling through the cracks Pt order sheet This is also a ncr form You don't have to jump on microsoft word and print it out It's a waste of time If you want to address motivation

 You better write him a note you are not to twist if you have something in your hands If you don't write it down your going to miss out on motivation He's not going to do what you tell him to do There's a way to never look at the computer screen If the patient doesn't have a medical diagnosis you can't start treatment You have 3 options if the doctor says it Just bill it You don't get paid Bill the patient

 I already rendered the care I assumed it was going to get done 2 weeks ago They're signing things all the time It's a technicality Are you using indefax First step toward a solution Insurance companies do not run health care Who regulates you? Your state board is the one who governs how you practice You have to have a medical diagnosis to treat

 You have to listen to the pt board You have or were ever told you have If that is left blank you cannot treat without a medical diagnosis The only stipulation is that person has to have a medical diagnosis You can't be the one to diagnosis If they tell you they have a medical condition, then you can treat It's your duty to evaluate the patient By law, under the governing board of your license, you have to evaluate that patient It's your obligation to evaluate that patient whether you get paid or not

 Being forgiven is very motivating Something is always coming up in the laws and regs Laser is not done as physical therapy Functional capacity evaluation form Pre employment screenings Don't spend more than 20 minutes in the exam room unless they're a really involved case Evals are not time based but they are capable of using modifiers How do we control destructive forces With the do's and don't s

 What is applying appropriate forces for lumbar disc protrusion Cannot stick him in a corset and not have him move They're not going to produce collagen The collagen will not lay down in an organized fashion Because they didn't apply appropriate forces while it was healing Got to start applying appropriate forces Pelvic floor exercises Another 2 weeks of applying appropriate forces How do we apply challenging forces

 Prayer stretches End range movements Do squatting with abdominal bracing Do it on trampoline, single leg Not jogging yet That comes in at restoring maximal forces Takes 8 weeks to rehab a disc protrusion of a 40 year old It's 2 weeks for every decade Tissues repair of grade 2+ or less tear I always treat the entire spine

 I shadow docs to learn how to better interact with patients You want me to go in and get the grip strength The left non involved is 32, 15,10 I take 3 measurements because if there is a diminishing effect then it's neurological Docs don't know what we know Educating is a good thing, but do it in a respectful way If massage makes a patient feel good, do it It's always mind over body Being fanatical about evidence based practice is ridiculous

 I would love to do this for you, but if insurance denies this, you will have to pay for this Start doing plyometrics Doing dynamic movements for 2 weeks Treatment plan is all over the place Have them doing lunges on 1st week of rehab on a disc protrusion, are you kidding me I like to find out who their physician is Punch card laser Liability waiver Calif is a non direct access state

 I'm going to ask them have you had any problems with your back before I don't need to see their mri Our diagnostics are more accurate than their mri Manipulations are high velocity thrust We're just doing gravity assisted Can do safely and gently on an osteoporotic patient You want to make the patient feel better every treatment Or their healing potential will close off I want you to practice this way Don't hire new grads

 They need more hand holding Needed forms Flow sheet Daily notes Exercise sheet Show a functional improvement If not, say why Make it up Show progress What they're doing is not fair If you don't have this you are vulnerable to scrutiny or insurance fraud

 Relay that your treatments are justified They want to say you are committing fraud I want them to look at your documentation and say you are untouchable What you have written down is evidence Avoid being brought into court If you show functional progress in your chart they can't charge you with fraud Put in the sets and reps and resistance in the exercise sheet Patient required physical, verbal cues to do exercise We have not had a chance to update our logs

 Ther ex has been recently scrutinized Have to show you offered some skilled intervention during exercise Pt board will hunt you down Small clinics are easy prey for the pt board You settle You don't want to go to court With ther ex you no longer can bill 2 units of ther ex Whether you altered their exercise or not It's not billable anymore But they are not telling you

 Supervision is not enough Ther ex is a one on one code Ther ex is what made up for all the different cuts It's so ridiculous Document that you offered some skilled intervention Do tactile cuing Taking advantage of our lack of collaboration Everyone is stabbing each other in the back in our profession Minimum of two written things of how you offered skilled intervention

 Just write something in Verbal, tactile cuing, progression, modification, facilitation, use these words at least twice If you don't put the right info the boxes if won't help you Put in the appropriate info into the boxes Stm grades The point of reference is always 4 The scale of stm is from 1 to 6 4 is halfway through the soft tissue or the muscle 5 is 75% through the muscle 6 is to the bone

 4 is 25% 2 is myofascial 1 is skin One page thing of jargon, abbreviation, and scales It will save you in an audit They know, you know Some of these charges are brought up because they couldn't find it They don't want to take back their mistake They are horrendous people They know you want to sleep at night

 They know you want to settle Discharge Start talking dc with the patient at the 4th visit Most practices are thinking discharge at the 12th visit Put yourself in the mind of the patient How do they feel about you There's some point where they loved you One window of opportunity Must catch it Critical discharge visit Most primed to bring in other patients

 It's typically the 4th visit Approach patient care as unlocking the healing potential I want you to come in one more time Go over your self management at home Curious where you're at How many more visits would you like How would you like to use it You got it Do you know anybody who's suffering from this condition Can you give this voucher or brochure and bring him in on the next visit

 This your discharge criteria Helps you in court against over utilization Primary functional impairment is 80% or better Independent hep 2/10 pain levels Clinical measurement 80% or better Independent self care Make this a policy Most important phase of rehab Acknowledging where the patient loves you the most

 Don't let them doubt you or lose their loyalty Only have one chance at this Give them a certificate of achievement For some people it means a lot to them It's the only goal they've ever met My bills were accurate My privacy was respected Post card to doc Zero out their account Give them a stack of brochures Do you know anyone suffering from these conditions?

 It's the dash you live in between 4 signature lines Senior PT, receptionist, senior aide, Discharge is the most fantastic part of the rehab process If anything happens over the next 60 days you are welcome back any time How many times a night are you having disturbed sleep because of their neck pain Any kind of functional and their ability to do that Must justify medical necessity What are some don'ts if they have a neck problem

 Better vehicle control Palms in up position while driving Sit about 10-12 inches from steering wheel When you start focusing You start becoming an authority An exercise for proprioceptive loss Sit Heel beneath your knees Start by pulling belly button into spine Squeeze groin muscles Palms on knees

 Push hands down into knee Keep palm pushing in Keep groin squeeze Breathe Squeeze shoulder bLades together Belly button in Squeeze groin muscles Push hands into knee Squeeze shoulders back Awareness in space where it is Partial sit to stand Hold it 2 inches off the chair

 100 times Pull belly button in 2-3 sets of 20 Hand over hand out front Have them keep stretching it, the psoas Right foot back Pull belly button in Raise left arm up toward ceiling More aggressive psoas stretch Kneel Put right hand on right buttock and squeeze right buttock

 Lunge forward If you have any back issues do these exercises I like to do a lot of things they can do on their own Curl, exhale, uncurl Bring it up 2 inches Sit there and let it stretch Lunge forward Through the touch of a caring human being people become healed